Tuesday, October 31, 2006

Bizarro Customer Of The Day......

It started off like any other of the dozens of numbnuts every day that insist on interrupting me while I'm trying to fill your prescription. Except.......there's no way I heard that right.

"I'm sorry, you want to know where the what is sir?"

"The neck stretcher"

Stunned silence from the drugnazi. A realization that he wasn't asking whether we carried a neck stretcher, but just needed a little guidance as to where it would be, confident that any corner drugstore would have such a thing.

The customer goes on to describe some sort of contraption involving weights and pulleys and hanging something on the other side of a door. His neck looked to be about average in length.

"OK drugnazi" I say to myself. "This is obviously some sort of joke, and he wants you to play along. "

"You're not talking about a noose are you?"

The customer was not amused. As he left we were both convinced we had just talked to the biggest goddamn idiot on the face of the earth.

This was followed by a lady demanding that I give her antibiotics because she didn't want to see a doctor. She was convinced she had an infection based on only one symptom, her heart was beating fast.

Release the scotch...........

Monday, October 30, 2006

As You Can Imagine, I've Been Called Many Things Over The Course Of My Career.

Ironically enough, I'm not sure I've ever been called a Nazi, although I couldn't rule out that possibility.

Tonight though, I was accused of taking advantage of vulnerable young women, many of them scared and desperate to escape a life of abuse, of winning their trust only to ruthlessly exploit their one and only asset for my own financial gain, keeping them under my spell using any means of violence necessary, using them until they were no longer of any value to me then abandoning their drug addicted, diseased shell of a former human self to an inevitable early death.

The customer was happy I was able to finish her prescription earlier than expected, and told me I was a pimp with a big smile on her face.

Surely it is a sign of my advancing years that it took me a while to realize I was being complimented.

And I'd like 2 Boxes Of Dirt For The Janitor's Supply Closet Please......

Overheard today in a conversation between the store manager and the district office:


"Oh.....and I need to order two copies of the anti-clutter manual"

That someone saw fit to create an "anti-clutter manual" is odd enough. The fact we needed two copies is confirmation yet again that I live in a bizarro alternate universe.

Saturday, October 28, 2006

I Never Realized Just How Much Of A Badass I Am. You Want A Piece Of Me Punk?

I admit it. Sliding pills across a plastic tray all day long can get a bit boring. So to help pass the time I'll occasionally come up with little projects to keep my mind occupied. Today for instance, as I swung open the gate to start the day's prescription action, I decided to keep track of how long it would be until a customer came to the counter that I judged I couldn't take in a fight.

Much to my surprise, I made it through the whole damn day. I could have taken them all.

Old ladies? They don't want none of me.

Mr. Early Vicodin refill? Hell, he'd probably pay me to kick his ass so he could go running to the urgent care for an upgrade to Norco.

Asthmatics? Please.

The only doubt came at around 2 o'clock with the 300 pound diabetic. As I took a good look at him, I realized the traditional kick to the nads might not work, as there was so much overhang from his belly I was pretty sure the family jewels were protected by a substantial fat layer. In the end I decided the "rope a dope" strategy made famous by Muhammed Ali would be the way to go. It took George Foreman 8 rounds to punch himself weary in the "Rumble In The Jungle", but looking over the diabetic, I knew five, ten seconds max and I would be ready to move in for the kill.

Other than that it was never even close. I am the Mike Tyson of pharmacy. To the old and sick of America I say only............. you have been warned.

Friday, October 27, 2006

You Think Jeffrey Dahmer Ever Worked Retail?

I'm Too lazy to post tonight, as I've got the late night/early morning thing happening at work, but fear not fans of the drugnazi, for I will leave you in the hands of linkee RomiusTexis. If there is a better description of the pain of retail than this post, I have not read it.

Do yourself a favor and click here now.

I Think The LSD Is Wearing Off Now. (Part III Of A Blog Trilogy)

Oh man, I should have known something was up when the balding, middle aged, paunchy white guy asked me to lick the stamp for his letter. Said his Viagra was giving him a dry mouth and he really needed to get this in the mail. Evidently it was his idea of a sick joke to slip the pharmacist some acid right before closing time. You wouldn't believe the things I saw. My hand melted. Caravans of Mexican supermodels were crossing the desert in Hummers with the air conditioning cranked. The lead Hummer was driven by a guy in a suit with a head that looked like a box of Tide. Freddy Mercury was in front of a Safeway wearing a wedding dress. Weird shit man. Thank God it was just some sort of bad dream.

So yeah.....sorry I couldn't post tonight. I'm gonna go sleep this off and be happy my hands are back.

My First Post As A Republican. (Part II Of A Blog Trilogy)

I'm a little nervous, you know, 180 degree turn in political philosophy and all, but here goes.

I don't understand why poor people hate America so much. I mean Jesus Christ, I wish I was poor. The dream homes of south central Los Angeles, the opportunity to live amongst the high society of Crips and Bloods, the glamour of waiting in line for food stamps. Yet all these ungrateful schmucks can do is gripe about how tired they are after working 2 seven dollar an hour jobs for 12 hours a day, or how they want an apartment without cockroaches. Hell, when I was a kid we couldn't afford ANY pets!

And what's the deal with all these illegal immigrants? Coming across the desert in caravans of air-conditioned Hummers to take all our jobs. Just yesterday they fired the pharmacist I worked with and replaced her with some guy named Javier. Javier doesn't speak English very well, but from what I understand, he told me he made the 3,000 mile trip from Oaxaca because he got bronchitis and he heard he could get a free Proventil inhaler in the US. He also said he wasn't willing to take any job that didn't pay at least $80,000 a year, and that 3 other people that snuck across the border with him now work as supermodels. Another is the CEO of Proctor and Gamble. Any intelligent person can see we must stop these immigrants to protect our way of life.

What I really need right now is a tax cut.

And the gay people. Don't even get me started on the gay people. What's with them coming up to me out of the blue and proposing marriage? Every time I try to go to the grocery store there's some mustached Freddy Mercury look alike there wearing a wedding gown asking me to radically alter the institution of matrimony. Obviously this is a part of the wider homosexual agenda Jerry Falwell keeps telling me about. If the gays aren't stopped then the terrorists have won, that's what I say, and if you don't think like me, then you're a liberal terrorist that hates America just like poor people do.

Oh, and my tax cut. If I don't get my tax cut the terrorists have won too.

Thursday, October 26, 2006

A Reader Shares Their Thoughts, And Changes My Life. (Part I Of A Blog Trilogy)

I should have expected this.

Using the word "liberal" in turn of the 21st century America is like waving a red flag in front of a bull. Except in this case the bull is usually a balding, middle aged, paunchy know it all white guy. Think of the guy who doesn't bat an eye when you tell him his Viagra isn't covered on his insurance plan then whips out his credit card. That kind of guy. I used the "L" word right in a post's headline, so sure enough right on cue the next morning this is waiting in my mailbox:

How can you call yourself a liberal? Your a Pharmacist, in the top 10% of all incomes in the good 'ole US of A. Do you like being taxed to death to fund all the sick lame and lazy people in this country. That is what your average tax and spend liberal wants. I hope you feel good about being a "liberal" every time a worthless state mediciad recipient comes into your Pharmacy. At least you will know where that 35% of your patcheck is going. If the liberals have there way it will be closed to 60%. At least then Mary Rottencrotch and her 16 kids from 16 different guys will be able to get Pulmicourt repules, Xopenex and Sigular chewable for all 16 kids minor runny noses. By the way your blog is funny as hell. Every Pharmacists goes through what you blog about on a daily basis. Its funny to read someone else observations of the ridiculous stuff we have to deal with.

My first thought upon reading this was an uncontrollable urge to raise taxes. That way we could afford to fund our public schools so someday I could stop getting comments with such disregard for the rules of grammar and spelling of the English language. Then I saw it. I read the message again to make sure. Yes. A connection to my very soul was being made.

I read the message a third time. What was so mesmerizing was how the words were obviously written just for me. The way AJ, the person who cared enough to write, didn't just spit up the same right wing drool that one can hear up and down the AM radio dial, see on Fox news, read in The Washington Times or hear wherever middle aged white people talk amongst themselves. AJ carefully took my thoughts on hospital charity care, which he obviously read very carefully, and by adding his own unique, personal take on what I had written, which he obviously read very carefully, was able to show me the error of my ways in a way Rush Limbaugh or Bill O'Reilly or the guys down at the elks lodge never could. Thank you AJ. Thanks to your intervention I now realize:

1) The fact I own property in the most insane real estate market in human history and drive a two year old paid for car are signs that I am being taxed to death.

2) That social services are the only thing the government spends tax dollars on. It really was a relief to find out that the war in Iraq, a war that I despise, a war that I hate with every past, current and future living part of me, is evidently not costing us a single dollar. Maybe Bush Sr. got a "buy one get one free" special on the first Gulf War. Republicans are smarter that the rest of you, and since I've only been one for about 5 minutes, I'll leave it up to them to explain how the free war thing works.

3) There is no such thing as a rich slut. That the fact Paris Hilton doesn't have 16 different kids by 16 different guys has nothing to do with the fact liberals have fought for a woman's right to contraception access.

I feel like AJ has removed the cataracts from my eyes, but also foolish for having wasted so many years taxing myself to death. I vow to you, to each and every reader of this blog, that I will make up for lost time. That I, the drugnazi, will so help me God turn this blog into every tax and spend hippie fornicator's worst nightmare.

Let's get started.

Wednesday, October 25, 2006

You Know Why I'm A Liberal? Because I'm A Selfish Bastard And The World Revolves Around Me, That's Why

I don't hate gay guys. Not at all. Why? Because every penis that decides to chase another penis means more women for ME! I wish all guys were gay, and not Rock Hudson in the closet gay either. I wish every single male besides myself were flamboyantly fabulous to the extreme Village People kinda gay, so there's no doubt for the ladies that I'm the only game in town. ME!

I want homeless people to get the help they need to make their sorry asses productive members of society. Why?

1) I want to walk down the street someday without seeing them , smelling them, or hearing them ask for my spare change.

2) If they get jobs, that widens the tax base, meaning I pay less. ME!

3) I have heard rumors that some homeless people might be mentally ill. If it turns out there is some truth to this, then getting them the meds that stop the voices in their heads will mean more business for, and therefore more money for......ME!

Evidently I'm not the only greedy bastard out there. It seems like a few hospitals have figured out that offering free care means more for THEM! That's right, giving away their product saves them money. I'll let today's New York Times explain:

AUSTIN, Tex. — Unable to afford health insurance, Dee Dee Dodd had for years been mixing occasional doctor visits with clumsy efforts to self-manage her insulin-dependent diabetes, getting sicker all the while

In one 18-month period, Ms. Dodd, 38, was rushed almost monthly to the emergency room, spent weeks in the intensive care unit and accumulated more than $191,000 in unpaid bills.

That is when nurses at the Seton Family of Hospitals tagged her as a “frequent flier,” a repeat visitor whose ailments — and expenses — might be curbed with more regular care. The hospital began offering her free primary care through its charity program.

With patients like Ms. Dodd, “they can have better care and we can reduce the costs for the hospital,” said Dr. Melissa Smith, medical director of three community health centers run by Seton, a Roman Catholic hospital network that uses its profits and donations to provide nearly free care to 5,000 of the working poor. Over the last 18 months, Ms. Dodd’s health has improved, and her medical bills have been cut nearly in half.


Now who do you think ends up paying the $191,000 tab patients like this ring up? That's right, ME! and YOU! through higher taxes and insurance premiums. So by being smarter about it's charity care, this hospital cuts our bill in half. More for everyone! But most importantly, more for ME!

The other alternative of course is to cut off all charity care and let poor people with diabetes, asthma, heart disease and other chronic conditions die in the streets. If you think this is a viable option, then seriously, I don't want to be in the same society as you. Please go to Alabama and form your own country, with my apologies that we didn't let that state leave the first time it tried. Getting back to the Times story:

Other answers to the insurance crisis are being tried around the country, including the creation of subsidized, bare-bones policies for small businesses. Vermont, Maine and especially Massachusetts are using combinations of state and federal money and employer mandates to extend insurance.

Still, only a fraction of the uninsured, in Central Texas and in most other states, are benefiting.

“All these local efforts are commendable, but they are like sticking fingers in the dikes,” Ms. Davis of the Commonwealth Fund said,


I suppose based on what I said earlier I should hate dikes, since they generally don't want me sticking fingers or anything else in them. From what I've seen however, the dikes are no great loss to the average straight guy.

Getting back to the point of this post though, the hospital in Austin becomes more.....liberal about it's charity care, ends up saving money and making more resources available for us all. Remember that the next time some gasbag, condescending caveman conservative tries to tell you liberal ideas just don't work in the real world.

Tuesday, October 24, 2006

Survey Says........18% Of People May Not Have Heard The Question

So I'm leafing through a copy of the trade magazine Drug Topics shortly before closing time tonight. I like reading a well-written publication that can hold your attention and even entertain a little while it keeps you up on the latest happenings in the profession, but I was leafing through the Drug Topics anyway. I was bored. Buried deep in an insomnia-busting piece entitled "Consumers happy with pharmacy experience" I find this nugget of information:

Eighty-two percent of respondents indicated that it was very important to have prescriptions filled accurately


Yesterday I would have thought this question too incredibly stupid to ask, today I learn almost 1 in 5 people don't sweat it too much if I fuck something up now and then.

Sweet.

Sunday, October 22, 2006

If You Are A Doctor That's Ever Written A Prescription For Pexeva, You Are By Definition A Numbnut.

I think we have finally hit bottom.

In the 20 months I've been tending my little blog garden, I've been keeping an eye out for the most pointless, inane, rip-off piece of crap peddled by Big Pharma. There has never been a shortage of contenders, and I can't think of a better way to spend part of my day right now than by going over a few. That's what I do. I'm the Drugnazi.

Niravam- An orally disintegrating form of alprazolam, an anti-anxiety med available for years as Xanax and as a cheap as dirt generic. Not only will Niravam cost you more than 5 times the price of generic alprazolam, but alprazolam tablets are among the smallest you're gonna find, making the benefit of an orally disintegrating version a little dubious. But hey, I suppose there might be one or two people out there a bit too retarded to swallow a tablet the size of a grain of rice. (Price comparison from drugstore.com)

Bidil- A combination of isosorbide dinitrate and hydralazine, two meds that have been on the market for years and are also cheap as dirt. Bidil combines the two old meds into one tablet, then markets itself to African Americans as a race specific remedy for heart failure. Of course there's no reason you can't prescribe the two drugs separately and save money, but hey, maybe it is easier for people to just swallow one tablet, and at least there is research to support the claim this combination of meds is more effective for black folks.

Moving up a level on the rip off scale we have:

Sarafem- The exact same fucking thing as Prozac. But hey, at least it comes in a different box so someone snooping in your medicine cabinet will just see that you're PMSing, not crazy.

Proquin XR- A pointless version of extended release ciprofloxacin, an antibiotic. But hey, the labeling says to take it with food, so they can claim it causes less stomach upset when taken as directed than the other extended release version of ciprofloxacin on the market, Cipro XR.

There's no way it can get worse than the med you are about to meet though, unless Big Pharma starts to make products that are actually less effective and more expensive than what they're designed to replace. Crap. Probably just gave them an idea. Anyway..... drum roll please.............

Introducing Pexeva. Brand name for paroxetine mesylate.

Paroxetine is already sold under the brand name Paxil. Paxil lost it's patent a few years back, prompting GlaxoSmithKline to introduce Paxil CR, itself a contender for most useless piece of drug crap ever. Pexeva though, is not a continuous release version of paroxetine. It doesn't come in a different package telling you it's for a different indication. It's not orally disintegrating. The maker of Pexeva, JDS Pharmaceuticals, has made it just different enough from Paxil (it is a different salt form, mesylate vs. HCl) that it isn't substitutable. Then they don't even respect your intelligence enough to try and bullshit you into thinking that makes any difference whatsoever in the two meds. They just want you to buy Pexeva, and pay 69% more for it than you would for generic paroxitine, (Price comparison from Consumer Reports)

Which leads to the question, why would any doctor ever write a prescription for Pexeva?

Because they're a dumbass, that's why. And if a Pexeva prescription is ever handed to you, tell your doctor I said so.

Saturday, October 21, 2006

President Monkey Boy And His Republican Bitches Face A Choice Between Helping Those In Uniform Or Helping Big Pharma. Guess Which One They Went With?

C'mon, you know as well as I do which one they chose. Sure, when it doesn't cost them anything, Republicans love to stand in front of the flag and a few hundred buzz-cut camouflage wearing hoo-ahs and proclaim their unwavering devotion to both. But when the rubber meets the road, or more specifically, when the campaign contribution meets governmental policy decisions, their true colors come out, and they ain't red, white, and blue. I'll let the military paper Stars and Stripes set the stage:

Pressured by the White House and drug industry lobbyists, Congress has killed a Senate-passed provision that would have forced pharmaceutical manufacturers to grant the Department of Defense deep discounts on drugs dispensed through the Tricare retail pharmacy network.


Key words: "Pressured by the White House and drug industry lobbyists"

The situation in a nutshell was this. A dispute arose as to whether a federal procurement law passed in 1992 that gave discounts to drugs purchased by the Department of Veterans Affairs also applied to drugs paid for through the Tricare retail network. The language in the law was evidently a bit ambiguous. The Department of Defense said "we get the same discount", Big Pharma said "in your dreams GI Joe", and the whole thing was headed to court. The situation was a lawyers wet dream. The Senate made a move to end the whole thing by putting language in this years defense authorization bill that made it clear that the men and women in uniform are indeed entitled to the same prices for meds as the men and women who used to wear the uniform. This set up a fight with the most well organized, well-prepared, brutally efficient enemy the military has ever seen. A fearsome alliance of Merck, Pfizer, Bayer, Sanofi-Aventis, Takeda Pharmaceuticals and others, representing forces of capital from the US, The United Kingdom, France, Germany, and Japan, sprang into action against our armed forces. George Bush, commander in chief, took a look at the situation and put the power of the presidency...... behind the worldwide axis of profit. Back to Stars and Stripes:

After the Senate passed its bill, White House politicos began to pressure House Republicans to fight the Senate provision in final negotiations over the defense bill, in effect, undercutting their own Defense Department as it strives to curb soaring drug costs.

“Tremendous forces” targeted conferees from the armed services committees as they began to negotiate over the bill, said a staff member. “Pharmacies, drug manufacturers … the politics went right through the roof.”


Key words: UNDERCUTTING THEIR OWN DEFENSE DEPARTMENT

You know how it ended. They may have fought bravely for what they believed in, but the armed services of The United States of America were quite simply no match for the Pharmaceutical industry. Perhaps someday we'll build a nice monument to those who so valiantly opposed the idea that the federal government should pay as much as it possibly can when it buys things. Maybe we'll give out some medals and ribbons as well.

After all, that wouldn't cost us very much.

Friday, October 20, 2006

My Employer Really Needs To Give Me More To Do......

.....because when it gets to the point where I'm bored enough to clean, bad things can happen.

Such a point was reached a couple weeks ago. It was a beautiful day and most people had sense enough not to waste it in a drugstore. This left me with a choice of staring blankly at the family planning section while listening to the likes of John Mayer serenade me through the in store music system, or do a badly-needed reorganization of the miscellaneous "we don't need this but don't want to throw it away" section at the back of the happy little pill room. I went with option one as long as I could, about an hour, before the sound of "No Such Thing" was like that of an icepick being driven through my eardrum.

Fine. I'll clean something.

One of the first things I found was a pile of old auxiliary labels. You know, the "may cause drowsiness" type stickers we put on your vial so our ass is covered when you take 10 Xanax then wrap your car around a tree. These days, most of them are printed along with your label and not put on separately, meaning the half empty box of "for anal use only" tags I found would probably never be used. How sad. If only there were some way for these little stickers not to go to waste.

I looked back at the family planning section.

Why not a little experiment? You know, in the name of science, the way the TV show "Candid camera" was all about science. I discreetly slipped over to where my favorite type of Trojans were on display. Two rows side by side, perfect. One row got the "for anal use only" stickers on their front corner, one didn't. After two weeks, here's what I can report:

3 boxes of anal condoms picked up and put back when the customer realized they weren't designed for the planned hole.

1 customer carefully looking over his options and going with the anal prophylactics.

1 customer question to me as to what the difference was. I assured the customer they were both the same product and was shocked, just shocked, that someone could be so immature as to put these stickers on as some sort of sick joke. The customer still went non-anal.

Today I saw the store manager taking the labels off, so these will be my final results. Damn.

Although I do still have some "for the ear" stickers left.......

Wednesday, October 18, 2006

From The "Actual Conversation With An Actual Customer" File....

At the end of this 12 hour work shift, my tired brain has but two memories of the workday, both quotes from the public:

Number 1

Me: I don't have this in stock right now, I could order it and have it here tomorrow morning.

Customer: What does that mean?

Number 2

Me: Do you have any type of insurance card that helps pay for your prescriptions?

Customer: No, but I have an insurance card.

I have not changed these quotes in any way, and the scotch cannot go down my throat fast enough tonight.

I hate everyone.

Monday, October 16, 2006

With This Post, I Save You $19.95,

So I'm answering my fan mail today, and for this I use a gmail account. For those of you not familiar with gmail, or the entity behind it that will soon be ruling the planet, I'll tell you that one of it's unique features is that alongside any e-mail message, gmail puts in text-based ads supposedly targeted to the topic being discussed. One of these ads in my mailbox today had a link to a site run by one Frank Buachie, who for a mere $19.95, will sell you the e-book "A Guide To Become A Pharmacist." not "A Guide To Becoming A Pharmacist" mind you, or "A Guide To Help You Become A Pharmacist," but "A Guide To Become A Pharmacist" Frank says of his e-book:

It comes with 30 days no question asked, money back guarantee.We will give you a full refund.

So what are you waiting for, you have nothing to loose. (emphasis mine)

Somehow this man couldn't find a publisher.

When I read over this cheap attempt to take advantage of poor students who want nothing more than a chance at a decent paying career, I was enraged, upset beyond belief that I didn't think of this way to rip off people first. So for no other reason than to show that I am a petty, spiteful man, I am going to tell you, right here, right now, how to become a pharmacist for free.

The process will start sometime around your junior year of high school:

1) If you see a class with chemistry and/or biology in the name, take it. Try to learn something.

2) If you are in a band, any band making any kind of music, drop out, as you will have to eliminate all right brain creative and artistic function. This does not apply to marching bands however, as i) marching bands don't make music, and ii) mindlessly following orders will help you immensely in your career choice.

3) Start thinking about colleges. Forget the Ivy league, the big state school known only for it's football team will do you just fine.


High School Senior year:

1) Take them chemistry and biology classes like you are crazy for the science.

2) Drop your creative writing class.

3) Start asking people if they have their prescription card with them. Practice being incredibly fucking annoyed when they don't.

3) Visit some college campuses and look for one with a lot of white people. Not poor white people, but preferably middle class white people who never got the memo they're not rich.

4) If you do not graduate in the top 10% of your high school class, immediately kill yourself, as your life is over. Or join the military.

Pre-pharmacy college years:

1) Foolishly show up on campus under the impression you are going to learn something about drugs sometime soon. Wash away your disappointment in a river of beer.

2) Master the process of counting by fives while waving a short metal stick from right to left.

3) More chemistry! Remember, you are a chemistry loving fool!

4) Start negotiations with Satan over the price of your soul. He will not offer enough to cover tuition.

5) Imagine for a few hours what it would be like to want to help people. This will help you write the required essay when the time comes to apply for pharmacy school.

6) Develop an intense hatred for the business major who lives across the hall from you. The same one that knocks on your door EVERY FUCKING NIGHT TO ASK IF YOU WANT TO GO BAR HOPPING! JESUS H. CHRIST DON'T THESE FUCKING BUSINESS MAJORS EVER HAVE TO LOOK AT THE INSIDE OF A BOOK AT ANY TIME IN THEIR COLLEGE CAREER? The experience you have with business majors during college will set the stage for relations with your district manager or hospital administrator throughout your working life.

Pharmacy School:

1)Congratulations! The second an actual college of pharmacy accepts your application, you never have to worry about grades again. Simply remember this GPA formula; 2.0=$110kyear

2) Show up for your first day of work as a pharmacy intern, feel the door close behind you, and as the chill settles into your spine, know that all joy is gone from your existence, forever.

3) Take a philosophy class. You need this class in order to graduate. No one working for the University seems to know why.

4) Still more chemistry. And they still haven't taught you how to make crystal meth.

5) Realize that gin mixed in orange juice really doesn't taste all that bad when you have no money. Lose your virginity to that girl in pharmaceutics lab who wears the coke bottle glasses and never talks.

6) You will have no recollection of anything that happens between mid-April of your last year of school and the end of your college career. Memory will fade back in as you walk across a stage wearing a gown and suffering from the worst hangover of your life. The president of the University will hand you a document you assume is your diploma. Upon opening it 5 days later, you see it is actually a student loan repayment schedule. Your first payment is already a week late.

7) Attempt to cram everything you've learned over the last 6 years into the 3 months you have to ready yourself for the pharmacy licensure exam. Realize you've learned nothing, rekindle the relationship with coke-bottle chick so you can sit next to her during the test and copy her answers.

8) Find out that yes, the condom did break and coke bottle chick is absolutely thrilled to be starting a family. Marriage certificate is issued on the same day pharmacy license arrives in the mail, officially documenting the end of your life.

At least now though, thanks to me you will have an extra $19.95 in your pocket before that day comes. I recommend spending it on a bottle of vermouth so you can quit pouring good gin in orange juice. That's just gross.

Saturday, October 14, 2006

Random Election Night Observations

At least it's election night for me, as California has a permanent absentee/early voting system that means you can sit down in front of the information superhighway and do your election research and voting all in one easy step. While doing so I come across the website of the candidate for governor of the Peace and Freedom party, Janice Jordan. At the top of one of the pages there's a picture of Ms. Jordan holding a giant banner reading "Free Leonard Peltier" and another of her being led away by the cops after being arrested at a San Diego protest.

Now I ask you, how the hell could I not vote for that? So I did.

Sure, the current governor thinks he's some sort of tough guy because he used to lift weights and pretend to fight aliens from a Hollywood movie set, but MY candidate rages against the man and gets led away by the pigs.

Sweet.

Those of you who regularly read my little blog garden also know I've been covering Dick Mountjoy's campaign for US Senate like a ribbed Trojan. My inner Beavis has been eagerly anticipating the moment when I would see the words "Dick Mountjoy" printed on official election material. My expectations were exceeded though when I opened my ballot envelope and saw this:







Huh huh......ok......so I understand wanting the name "Richard" on your ballot line. But then to go out of your way to make sure "Dick" gets in there as well.....in quotation marks! BBBBWWWAAAAHHHAAAAAHHHHAAAAHHHHAAAAHHHHH!!!!!!! It's like someone at the print shop hates him and decided to stick in a random insult.

Immaturity can so lift the spirit sometimes.

Friday, October 13, 2006

The Institute Of Medicine Tells The FDA To Stop Being Big Pharma's Little Bitch Boy

Some of you in the profession may have noticed, around the time you were packing up a new wonder drug to be sent back to the manufacturer for the 6th, 7th, or 8th time, that there seems to have been a problem develop with new drug safety over the last few years. You may have noticed, but your government seems to have been a little slow. Maybe they like issuing recalls because it makes them feel all powerful and stuff. Maybe they let safety standards fall because more than half the budget the FDA spends to test new drugs comes from the pharmaceutical industry that submits the new drugs for review. I'll let you decide which is more likely. Regardless of the reason however, after Rezulin, Baycol, Bextra, Duract, Posicor, Propulsid, Tequin, Redux, Seldane, and Vioxx, the FDA had enough. It was time for action.

A study was commissioned. I wish that were a joke, but it's not.

For what it's worth, the study was released at the end of last month, and it did not have kind things to say about the FDA. According to the New York Times:

The report’s conclusions are often damning. It describes the Food and Drug Administration as rife with internal squabbles and hobbled by under financing, poor management and outdated regulations.

“Every organization has its share of dysfunctions, unhappy staff members and internal disputes,” the report said. But panel members said that they were deeply concerned about the agency’s “organizational health” and its ability to ensure the safety of the nation’s drug supply.

That's all well and good for those of us who are fascinated with the latest FDA gossip, but after 10 new drug recalls that I can think of off the top of my head while in a bit of a scotch induced haze, I'm thinking we need to have some proposed solutions. Fortunately the study has some. Back to the Times:

The report made these recommendations, most of which would require Congressional authorization:

¶Newly approved drugs should display a black triangle on their labels for two years to warn consumers that their safety is more uncertain than that of older drugs.

¶Drug advertisements should be restricted during this initial period.

¶The F.D.A. should be given the authority to issue fines, injunctions and withdrawals when drug makers fail — as they often do — to complete required safety studies.

¶The F.D.A. should thoroughly review the safety of drugs at least once every five years.

¶The F.D.A. commissioner should be appointed to a six-year term.

¶Drug makers should be required to post publicly the results of nearly all human drug trials.


The most controversial of these recommendations appears to be the advertising restrictions. The press conference called to announce the study's findings was interrupted at one point by a rabid beaver and an actor dressed as Abraham Lincoln. The beaver reportedly ran amok biting commission members in the kneecaps, while the actor playing Lincoln repeatedly fired a musket in the air in an attempt to halt the proceedings. After 20 minutes of anarchy, both the beaver and Lincoln settled into a restful sleep and the press conference continued.

Nah, I made that last paragraph up. I still can't get over those Rozerem ads.

The real reaction from the FDA was.....hmmm, searching for the right word.....wussy. Again to the Times:

In a telephone conference with reporters on Friday, top F.D.A. officials struck an awkward balance between thanking the institute for its work and defending their own leadership. They said they needed to study the report before deciding which of its recommendations to endorse.


So they have to study the study. I have an idea. Maybe they could create a commission to study the study that they commissioned.......*sigh*

When they are done studying the study, the Times story says that most of the changes would require Congressional authorization. This is where you come in. Your member of Congress is up for election next month. They all are. Can you trust your representative to put the interests of real people above those of the "artificial persons" that are corporations? If you're not sure, there's a easy way to tell. If they have a "R" after their name on the ballot the answer is no. If they have a "D" after their name the answer is "maybe, depending on which corporation is involved."

Good luck to us all.

Thursday, October 12, 2006

Halloween Is Satan's Feast Day.

Whenever I hear those words I am flooded with happy memories of my college years, and I'm sure you understand why.

No you don't. You see, the university that was foolish enough to grant me a pharmacy degree was located in the middle of nowhere. Unless someone has moved it, it still is. There was only one road away from campus that led from nowhere to somewhere, and along that road every year in the fall someone would rent a billboard with nothing but those five simple words upon it. I never quite figured out what they intended us to do with that information, but that's not the point. Whenever I saw it, I was a happy dumb college frat boy heading into town looking for dumb college frat boy things to do during the best time of the academic year, the precious few weeks of the term when everything surrounding us wasn't frozen solid. Good times...... *sigh*

Flash forward to today, when a customer asks to see the manager. She had a very urgent tone about her, like she knew the date of the next North Korean nuclear test and had to pass the information along to the proper authorities.

I asked the sometimes-suicidal question, "Is there something I can help you with?"

"No, I need to talk to the person who runs the store"

Whatever. I called the manager up and resumed the pill counting action, only to be stopped a few moments later when I hear the lady shout "Halloween is for Satan!" look up and see her pour a bottle of water over some cheap made in China witch doll that was placed by the pharmacy register. I shit you not. Evidently the lady took the climatic scene in The Wizard Of Oz a bit too closely to heart.

The customer was either some fundamentalist Christian or bat-shit crazy. I never bothered to find out. Like there's a difference.

Tuesday, October 10, 2006

A Quick Hit Of Customer Wisdom To End The Day

So I ask the lady if she has any questions about her Levaquin prescription and hear:

"Oh no, I know how you can't just go around taking it like an antibiotic when what you need is an antibacterial."


This doesn't even make any sense. And it was delivered in a tone that made it clear she thought there was nothing I could teach her about her Levaquin, which is an antibiotic. Antibiotics work to kill bacteria.

Making a difference in people's lives, that's what I do. Where's the scotch.......

A Rozerem Update; It's Not A Groundhog After All

Today I found out the most bizarre advertising campaign ever is more surreal than I first thought. If you've seen any of the ads for the new wonder pill Rozerem and you're anything like me, you've probably been saying to yourself, "What in the hell do Abraham Lincoln and a groundhog have to do with the treatment of my medical problems?" I am not making this up. A marketing drone plugging away somewhere thought that the man who had what was probably the least tranquil administration in American history combined with a large rodent would be a good way to sell a sleeping aid, then managed to sell the idea to Takeda Pharmaceuticals.

I foolishly assumed the rodent was a groundhog, because they are famous for sleeping all winter, then having some retard human wake them up in February to ask them when the weather is going to get warmer. Sleeping pill, sleeping groundhog, right?

Nope. I found out today from a sales rep slightly more helpful than this one that the rodent is actually a beaver. I think a beaver is still a rodent. I'm not sure, and I don't feel like looking it up right now. What I do know is that in contrast to the sleepy groundhog, a beaver's claim to fame is it's reputation for being "busy," felling trees, building dams, that kind of thing.

This busy, hardworking animal, who by the way in the ads is something of a smartass, is supposed to make you want to buy a sleeping product, along with the man who presided over a war in which over 373,000 people died. I'll bet that made Lincoln sleep really well at night.

Surely there's something I'm not getting here.

Monday, October 09, 2006

Why I Hate Telling People I'm A Pharmacist

Because the image makers of society want you to conjure up images like this when you hear the word "pharmacist," that's why:




Can't you just hear the woman who looks incredibly like David Bowie saying in that deadly serious, deep voice of hers,

"Mrs. Smith......I don't know how to tell you this......but....I'm afraid it's.....DRY MOUTH. We'll get through this.....I want you to know Mrs. Smith, I'm here to help you....every step of the way.

The pharmacist looks far more upset at this turn of events than Mrs. Smith. Maybe that's because Mrs. Smith is unable to talk with no spit in her mouth.

So when people ask what I do for a living I tell them I'm an astronaut. It's really easier to fake being one than you might think. I mean how many people do you know who have been to outer space? So there's no way they know I'm lying when I start quoting random things I remember from the movie The Right Stuff. Most people are awed into silence, women seem intimidated, most likely from the powerful sexual imagery that thoughts of a rocket moving upwards at full throttle put into their subconscious mind. Once a guy tried to start something with me by insisting the moon landing was staged in a Hollywood studio, but when I let him in on the secret that the Earth was actually flat like a Frisbee, he ended up buying me a couple drinks.

It's not always easy being a fake astronaut, but at least in that world I've never had deal with a unique approach to saliva replacement.

Sunday, October 08, 2006

The Prescriptions Could Not Have Been More Appropriate.....

Now, I don't spend much time around children, for many of the same reasons I don't spend time around wild boars, but I have never seen anything like the little out of control shit whose mom I had the good fortune of waiting on today. He announces his presence by throwing a volleyball for no apparent reason straight up and hitting the store's ceiling, sending said ball ricocheting down and almost hitting him on the head. Society should be so lucky, as it would have been more of a behavior deterrent than anything mom could offer.

"I don't like that Johnny" she says, as Johnny runs down the vitamin aisle.

A loud scream. Something like you might imagine coming from the mouth of the mythical banshee. Then "Johnny, if you don't settle down there will be no video tonight."

A loud crash out of my sight. "Johnny, did you hear me? Behave or no video. This is not OK"

Johnny and I both knew that if he went home and deliberately set the house on fire, mom would rush into the burning building to save the DVD player and Johnny's five favorite cartoon discs.

Then the pharmacy door opens and in comes Johnny. Running at full speed behind me and into the room of drugs. The drugnazi corners little Johnny and leads him out by the ear. Now I'll give the kid credit, they say children and animals always know a persons real intentions, and Johnny seemed to sense that the only thing keeping me from slapping his sorry little ass into last year and giving him one more chance to not to become a screw-up was the legal action that would result. Johnny also seemed to know that much more of this and even that wouldn't stop me. He finally sat down in a chair and gave me a chance to wait on mom.

She was picking up prescriptions for a Nuvaring and Lexapro. That would be a contraceptive and an antidepressant for those of you not in the profession.

It would seem mom learned her lesson a bit too late.

Friday, October 06, 2006

Pharmacy Art Picture #1

I took this through the drive-through window of a store in a god-forsaken ghetto where I used to work the overnight shift (calling it the "graveyard" shift hit a little too close to home) I wanted to get the sunrise over the building's garbage infested rear parking lot and make some sort of statement that there are moments of beauty no matter where you find yourself, but got this mostly reflective back-at-you shot instead, thereby making an entirely different statement.

That statement being of course, that I'll take all the time I damn well please to fill your prescription when I have a new cell phone camera to play with.

Sometimes Jesus Just Loves You A Little Bit.

So I'm being a good pharmacist for some reason today, and noticing that the lady's new thyroid prescription is different from the dose she's been taking for the last 5 years, I make a note to mention it when she picks it up. This is what a pharmacist in the 21st century is supposed to be doing, being proactive in looking for mistakes. A generation ago, I would have been expected to keep my mouth shut and just put the damn pills in a bag. Free love, a real anti-war movement, and less contact with customers. Just three of the reasons I was born 20 years too late, but I digress.

So thyroid woman comes to the counter and I say something like "looks like your dose has gone down a little bit from the last time you've had these filled." She thinks I'm being friendly. What I'm really doing is watching her face for signs of surprise. Sadly, this is what I got instead:

"Oh yes, it's just the most wonderful thing. I prayed and prayed to Jesus and he answered me like I always knew he would."


OK.......so, Jesus heard this lady's prayers, and instead of CURING her, he decides to change her condition just enough that she requires 0.000137 of a gram of thyroid replacement hormone a day instead of 0.000150 of a gram. She'll still have to take a pill every day, with the same consequences if she misses a dose or stops therapy. Long term prognosis? Same. Price of her prescription? Same. As a matter of fact, if her doctor hadn't been on top of things and noticed the change in her condition, she could have easily remained on a dose that was now too high for her, so really you could say that Jesus needlessly put this woman's health at risk.

Lesson learned for me. Next time I swear I'm just keeping my mouth shut and putting the damn pills in the bag.

Tuesday, October 03, 2006

I So Need A New Look.....

....so I'm walking down the street to lunch today, in my workshirt and tie and all....and a homeless guy asks me if I'm a Mormon. Christ, talk about hitting below the belt. See if you get my spare change on the way back now fucker.

A Political Update. The Dick Mountjoy Campaign Appears To Have Gone Flaccid

Some of you may remember my earlier delight upon hearing that former California State Senator Dick Mountjoy had won the Republican nomination to seek a promotion to the United States Senate this fall. (I'm not making this up, here's his website.) I looked forward to a long, hard campaign where Dick Mountjoy's unbending commitment and unequalled endurance would thrust the issues that excite the people of California to the forefront again and again, leading to a cathartic climax on election day that would release the tension that had built up all over the Golden State.

But now that the passion of election season is heating up all over the country, it would seem Dick Mountjoy is missing the excitement necessary to have a relationship with California voters. Everywhere politicians are on the TV, blaring from the radio, and plastered in the newspapers accusing each other of wanting to raise your taxes and the price of gas, but as the weather gets colder, the Dick Mountjoy campaign seems to be shrinking away from it's job of injecting debate into this election season. So I went looking for Dick today and discovered this, from MSNBC.com:

If the 2006 election for California's U.S. Senate seat were held today, would you vote for:

FEINSTEIN 53%

MOUNTJOY 23%

OTHER 3%


It would seem that support for Dick Mountjoy is too soft for him to become a fully functional candidate, much to the frustration of his partners at the California Republican Party, who despite their assurances that this kind of thing happens to a lot of candidates, have turned their attention elsewhere, leaving Dick Mountjoy feeling very inadequate next to the likes of Arnold Schwarzenegger. I'm sure however, that even though it is almost certain we won't have Mr. Mountjoy to kick around after November, there will always be plenty of Dicks in politics.

Monday, October 02, 2006

Abraxis BioScience Says It's Breast Cancer Drug Is A Breakthrough, Then Calls Itself A Liar

Patrick Soon-Shiong is an American success story. Probably by definition anyone who is ranked #77 on the Forbes list of richest Americans would be considered as such. Ever wonder what it is that separates those few who reach that level of achievement from you and I? I mean most of us get up each day, work hard, have some ambition to make something of ourselves. So what is it that can drive someone into that elite group of 100 people with more money than everyone else in the country? Ripping off hospitals is a nice start, but to really make it in the big leagues of American finance, being willing to fleece cancer patients who are afraid of dying is just the kind of thing that will drive you right to the top.

In the mid 90's, Dr. Soon-Shiong made his move into the entrepreneurial class by forming his own company, American Pharmaceutical Partners, to sell generic drugs to hospitals. His move into the business world might have been prompted by a surgical technique he pioneered turning out to be a total flop, but only he would know that for sure. The good doctor thought it might help sales at his company if he gave stock options in American Pharmaceutical Partners to people who were responsible for buying his products, and wouldn't you know, the strategy of giving people who are spending hospitals money, not theirs, a chance to make money for themselves, not the hospitals, by choosing Dr. Soon-Shiong's products worked out pretty well for him. Yes there were people who whined and cried about things like "conflict of interest", but they were probably just jealous communists. You can't stand in the way of capitalism, baby.

You can't stand in the way of capitalism because capitalism improves the lives of us all, by bringing us advances like Abraxane, a new and improved treatment for late-stage breast cancer. By "new" of course, I mean "slightly different and not proven to be any more effective than what's already on the market." Abraxane is a reformulated version of paclitaxel, which has been sold under the brand name Taxol to treat cancers of the lung, ovaries, and breast since 1993. Because Taxol isn't water soluble, it has to be given in a mixture of castor oil and alcohol than can cause severe allergic reactions. To lessen the risk, people are given a steroid and an antihistamine along with the Taxol. Kinda sucks, but beats the hell out of no cancer treatment at all.

The idea, and by idea I mean "hype," behind Abraxane is that by reformulating paclitaxel into a form that makes the steroids and antihistamines unnecessary, you can cut down on side effects and increase efficacy. Dr. Soon-Shiong says of his product
“We have a breakthrough, Look at the data.” OK then, lets look.

- Taxol causes more damage to white blood cells, Abraxane causes more damage to nerves.

- In a trial of 454 late stage breast cancer patients, Abraxane delayed the growth of tumors for 23 weeks in the average patient, compared with 17 weeks for Taxol.

- There was no difference in the amount of time a patient lived in the study, regardless of which med was used. After two years, roughly 75 percent of patients in the study had died, whether they received Abraxane or Taxol.

That's the data Dr. Soon-Shiong says proves his product is a "breakthrough"

To be fair, when he used the word "breakthrough" Dr. Soon-Shiong might not have been talking about the science at all, but rather the price his new company, Abraxis BioScience, is able to get away with charging for Abraxane

$4,200 a dose. Twenty-five times as much as the generic version of Taxol. I shit you not.

Twenty-five times as much for a drug that hasn't been shown to help you live one day longer.

Twenty-five times as much for a drug that a cancer research journal concluded is “old wine in a new bottle.”

Twenty-five times as much when Dr. Michael Hawkins, top medical officer for Abraxis BioScience says “These are just two forms of paclitaxel”

Did you get that last quote? Dr. Hawkins works for the company that makes Abraxane, and he's saying “These are just two forms of paclitaxel”? WTF?

You see, Abraxis BioScience wanted a new indication for Abraxane to use in early stage breast cancer, but they didn't want to do any more studies, so Dr. Hawkins was saying the FDA should just go ahead and approve it since Abraxane is just like Taxol, and Taxol already had the indication.

Got that? When they want to charge you $4,200 instead of $150 it's "a breakthrough." When they want to get out of doing more studies it's "just another form of paclitaxel"

An American success story indeed.

Read more here.